What insurance policy changes affect code O00.131?

There are 8 tracked policy changes affecting code O00.131, including updates from UnitedHealthcare. Each change may modify coverage criteria, reimbursement rates, or prior-authorization requirements.

Which payers have updated policy for code O00.131?

Payers that have issued tracked updates for code O00.131 include: UnitedHealthcare.

How do I get notified when code O00.131 policy changes?

Create a free account at PolicyChanges.app and save a search filtered to code O00.131. You will get an email when new policy changes reference this code: daily or weekly, your choice, on every plan.

Why do payers change policies for code O00.131?

Payers revise policies for individual billing codes to align with updated clinical guidelines, CMS rule changes, fraud and abuse prevention measures, or network cost-management goals. Changes can affect medical necessity criteria, place-of-service restrictions, bundling rules, or whether a code requires prior authorization.

PAYER POLICY CHANGES

O00.131 Insurance Policy Changes

code O00.131 is referenced in 8 tracked payer policy changes from UnitedHealthcare. For billers and coders, staying current on payer-specific coverage criteria, reimbursement rules, and prior-authorization requirements for code O00.131 is critical to clean claim submission. Each entry below links to the full policy analysis with effective dates and action steps.

UnitedHealthcare · Effective Oct 1, 2026High impact
Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (UMR)
UnitedHealthcare's UMR medical policy update bulletin for October 2026 says the annual ICD-10 and quarterly CPT/HCPCS code changes took effect October 1, 2026 across its medical and drug policies. The billing team needs to add the new CPT, HCPCS and ICD-10 codes to charge entry, stop using the codes that were removed, and update the revised descriptions. The bulletin lists the code changes but does not state any coverage decisions beyond the policies it updates, so the practice should check each updated policy before billing the new codes.
UnitedHealthcare · Effective Oct 1, 2026High impact
Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Surest)
UnitedHealthcare's Surest medical policy update bulletin for October 2026 says the annual ICD-10 and quarterly CPT/HCPCS code changes took effect October 1, 2026 across its medical and drug policies. The billing team needs to add the new CPT, HCPCS and ICD-10 codes to charge entry, stop using the codes that were removed, and update the revised descriptions. The bulletin lists the code changes but does not state any coverage decisions beyond the policies it updates, so the practice should check each updated policy before billing the new codes.
UnitedHealthcare · Effective Oct 1, 2026High impact
Preventive Care Services
UnitedHealthcare's individual exchange (ACA marketplace) preventive care policy was updated effective October 1, 2026, which is already in effect. The update refreshed the pregnancy ICD-10 diagnosis codes, added several sudden cardiac arrest and death diagnosis codes while removing two, added breast MRI codes 76014 through 76019 and A9573 for completing breast cancer screening, and clarified that certain colonoscopies may need a site of service review.
UnitedHealthcare · Effective Oct 1, 2026High impact
Preventive Care Services
UnitedHealthcare's commercial preventive care policy was updated effective October 1, 2026, which is already in effect. The update refreshed the pregnancy ICD-10 diagnosis codes, added several sudden cardiac arrest and death diagnosis codes while removing two, added breast MRI codes 76014 through 76019 and A9573 for completing breast cancer screening, and clarified that certain colonoscopies may need a site of service review.
UnitedHealthcare · Effective Oct 1, 2026Medium impact
Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Exchange)
Effective October 1, 2026, UnitedHealthcare updated several Individual Exchange medical policies to match the annual ICD-10 and quarterly CPT/HCPCS code changes. The bulletin adds many new codes across areas such as cardiology, pregnancy, hematology, genetic testing and pain or rehabilitation, and it removes a smaller set of older codes.
UnitedHealthcare · Effective Oct 1, 2026Medium impact
Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Commercial)
UnitedHealthcare's Commercial medical and drug policies were updated effective October 1, 2026 to match the annual ICD-10 and quarterly CPT/HCPCS code changes. Codes were added, revised or removed across topics including genetic testing, molecular oncology, cell therapy, pregnancy preventive care, sudden cardiac arrest risk and Category III codes, so the billing team needs to update its code lists and charge entry tables to match.
UnitedHealthcare · Effective Oct 1, 2026Medium impact
Preventive Care Services
UnitedHealthcare updated preventive care coverage effective October 1, 2026, adding new CPT codes for breast MRI screening (76014-76019, A9573), expanding cardiac risk assessment diagnosis codes, and clarifying that certain colonoscopies may require site-of-service review. Multiple ICD-10 diagnosis code lists were updated for pregnancy-related conditions, cardiac conditions, and genetic/family history risk factors.
UnitedHealthcare · Effective Oct 1, 2026Medium impact
Preventive Care Services
UnitedHealthcare and Surest updated the Preventive Care Services medical policy, effective October 1, 2026. The changes add or remove diagnosis codes for pregnancy, sudden cardiac arrest and family history, add breast MRI codes used to complete a breast cancer screening, and clarify that some colonoscopies may need a site of service review.

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Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (UMR)

Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Surest)

Preventive Care Services

Preventive Care Services

Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Exchange)

Annual ICD-10 and Quarterly CPT/HCPCS Code Updates (Commercial)

Preventive Care Services

Preventive Care Services

What insurance policy changes affect code O00.131?

Which payers have updated policy for code O00.131?

How do I get notified when code O00.131 policy changes?

Why do payers change policies for code O00.131?